Need Input on Surgeon and Model

[sambalamba]

The one touch pump of Coloplast also makes the noise. So if noise is an issue, I recommend you go for an AMS. AMS is known to be more natural and your measurements suggest it would be a good choice. I wouldn’t base my decision on whether doctor leaves you with a catheter post surgery or not. In my case I had significant issues post surgery to pee and I was actually hoping I had a catheter in place. So I do understand where Dr. Eid comes from when he recommends having the catheter for an extra 2-3 days.
You have 2 good choices in surgeons and can’t really go wrong with either. Look at who will be more convenient logistically and insurance wise.
Good luck!

Hi Atul,

Dr. Eid was quite vocal about his concerns with the OTR pump when I visited him a few months ago, stating that it’s much more prone to tubing failure compared to the Classic pump. In fact, he said he's only been recommending the Classic pump to his patients for this reason. I’m not sure if Coloplast has addressed this issue or made any updates to the OTR pump to resolve it. Do you have any insights or thoughts on this?

[sambalamba]

You can get plenty of girth from a CX. My dr started cycling at day 3. Eid isn't the only early cycling dr in the USA.

Hi GT1956,

When you started cycling at just 3 days post-op, were you still dealing with significant pain or swelling? If so, how did you manage to continue cycling while handling the discomfort? I’d be really interested to know how you worked through that early stage.

[Gt1956]

You can get plenty of girth from a CX. My dr started cycling at day 3. Eid isn't the only early cycling dr in the USA.

Hi GT1956,

When you started cycling at just 3 days post-op, were you still dealing with significant pain or swelling? If so, how did you manage to continue cycling while handling the discomfort? I’d be really interested to know how you worked through that early stage.

Ha, that is easy to answer. Cycling at three days consisted of two or three pumps. Even at that, they weren't full pumps to get a hard bulb. A little feeling around lets you find a spot that has less pain. Three pumps was bearable. Deflating was relatively easy. Oh, it might help to take an ibuprofen 30 minutes before pumping. Its not as bad as you might think. They generally advise to give your pump a small pull down several times a day. I gave it a nudge everytime I went to the bathroom or cycled. You just need to set your mind to it & find the least painful way to do it.

[atul21]

Hi Atul,

Dr. Eid was quite vocal about his concerns with the OTR pump when I visited him a few months ago, stating that it’s much more prone to tubing failure compared to the Classic pump. In fact, he said he's only been recommending the Classic pump to his patients for this reason. I’m not sure if Coloplast has addressed this issue or made any updates to the OTR pump to resolve it. Do you have any insights or thoughts on this?

Yes, Dr. Eid has been advocating for the classic pump. When I visited him in early 2023, he had told me that around 2021 he faced a lot of OTR tubing failures which he had reported to Coloplast. Initially Coloplast denied it, but later they did come back to him and indicated they may have had an issue with the tubing. Of course Coloplast did not admit publicly as that would lead to a class action. As course correction they changed internal mechanisms and now tubing should have been ok. But he said he has no way to check or know. Also tubing for the one touch was/is made by a 3rd party.
So seeing all this history behind the pump he recommends the classic.
Having said that, the classic is available only in the USA and not anywhere else as far as I know. Coloplast wouldn’t be a fool to not rectify an issue for so many years. But if it gives you peace of mind, choose the classic pump as it is available to you.
Good luck!

[atul21]

I think it would be interesting to figure out how many people had tubing failure in OTR pump who got implanted during the 2020-2021 against those in 2022 onwards. I have seen a few here who got implanted in 2021. But that is just an observation and not any scientific analysis.

[LastHope]

It appears like 2022 also had its share of issues according to Health Canada.

Lot # 8806754
Titan Touch Model ES2920

Issue
Pump bulbs are manufactured using 2 molds. A component on one of the two molds shifted during production. This resulted in a gradual build of material on the mold, which gradually decreased wall thickness of the pump. This occurred over the course of several weeks, culminating in a period of time (17 September 2022 to 02 December 2022) where pump bulbs were manufactured below the wall thickness specification.

Original published date: 2023-11-10
Published by Health Canada
Recall Class : Type II
Identification number
RA-74577

[sambalamba]

Thanks, Atul and Lasthope.

I’d like to touch on another topic that I haven’t seen discussed much in the forum. I may create a separate thread on this later, but I’d appreciate folks thoughts here first.

The question revolves around implant diameter and how much space it takes up in the corpora, and, in turn, what happens to the remaining corporal tissue. For instance, if someone with narrower corpora chooses a Titan, wouldn’t the expansion of the implant fully compress the leftover corporal tissue when fully inflated? This could potentially restrict any blood flow to the remaining tissue during erection, leading to thinning or even tissue death over time due to the lack of blood flow. On the other hand, if a narrower AMS cylinder was used, it might compress the leftover tissue less, theoretically allowing more blood flow into that remaining tissue.

Is this the right way to think about it? Could the choice of a narrower implant actually help preserve some of the natural tissue by maintaining some level of circulation, or is the effect of compression more or less the same regardless of implant type? Wondering about how this plays out in the long term

[atul21]

Thanks, Atul and Lasthope.

I’d like to touch on another topic that I haven’t seen discussed much in the forum. I may create a separate thread on this later, but I’d appreciate folks thoughts here first.

The question revolves around implant diameter and how much space it takes up in the corpora, and, in turn, what happens to the remaining corporal tissue. For instance, if someone with narrower corpora chooses a Titan, wouldn’t the expansion of the implant fully compress the leftover corporal tissue when fully inflated? This could potentially restrict any blood flow to the remaining tissue during erection, leading to thinning or even tissue death over time due to the lack of blood flow. On the other hand, if a narrower AMS cylinder was used, it might compress the leftover tissue less, theoretically allowing more blood flow into that remaining tissue.

Is this the right way to think about it? Could the choice of a narrower implant actually help preserve some of the natural tissue by maintaining some level of circulation, or is the effect of compression more or less the same regardless of implant type? Wondering about how this plays out in the long term

My layman guess to this would be that it would not matter as most of the time your implant will be in deflated state. And when deflated there would be no pressure exerted on the corpora.
The only thing which most doctors say is that if you have a higher girth we recommend the titan to preserve it.

[LastHope]

I think Atul makes a great point.

I'd like to add my 2 cents. According to a study published in the Journal of Sexual Medicine, the Titan was found to help with gains in length and girth for up to a year. From Dr. Clavell's excellent talk, I understood that the surgical capsule that develops around the cylinders can keep expanding by cycling and fully matures by the 1 year mark and the chances of it getting compressed further away after a year is low. This fibrous capsule, I believe, also acts as a sheath, forming a protective barrier to the remaining cavernosal tissues. While the development of tissue atrophy around any foreign material in the body over decades, and the resultant thinning of tissues, cannot be ruled out, especially since the rate of atrophy varies greatly among individuals depending on their metabolic health and comorbidities, the formation of the fibrous capsule is a welcome effect (like a leather wrap) for the implanted individual.

https://youtu.be/vTV7Dazv6gI?si=BeZw_KFW_iAgzZLA

https://www.sciencedirect.com/science/a ... 9515310171

[tomas1]

I can't ever remember hearing about weaker erections, one of Clavell's concerns.

1. AMS or Titan?
I’m leaning toward the AMS for its comfort, better concealability when flaccid, and the quieter pump. Additionally, it puts less pressure on my thinner penile tissues due to its narrower cylinders. However, if this comes with the risk of weaker erections both now and in the future, I’m more inclined to go with the Titan as my first implant.

What is a weak erection? I obviously have had the CX for almost 6 years, and it has never changed.

The CX cylinders are supposed to be smaller in circumference which may be better of your girth.
Maybe the Tital would give you a more oval dick. I have one small "dog ear" and would not want more of them. It's not a big deal, but I'd rather not have it.